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Susan M. Stover - One of the best experts on this subject based on the ideXlab platform.
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case control study of high speed exercise history of thoroughbred and quarter horse racehorses that died related to a complete Scapular Fracture
Equine Veterinary Journal, 2013Co-Authors: S A Vallance, Peta L Hitchens, Rachel Entwistle, Ian A Gardner, Susan M. StoverAbstract:Summary Reasons for performing study: Identification of exercise history patterns that are related to catastrophic Scapular Fracture will facilitate prevention of racehorse fatalities. Objectives: To determine if exercise patterns are associated with Scapular Fracture in Thoroughbred (TB) and Quarter Horse (QH) racehorses. Methods: High-speed exercise histories for 65 TB and 26 QH racehorses that had a complete Scapular Fracture (cases) and 2 matched control racehorses were retrospectively studied. Exercise variables were created from lifetime race and official timed workout reports. Associations between exercise variables and Scapular Fracture were investigated using conditional logistic regression. Results: Thoroughbreds with a Scapular Fracture had a greater number of workouts, events (combined works and races), and mean event distances than QHs with a Scapular Fracture. Quarter Horses worked less frequently and accumulated distance at a lower rate than TBs. Breed differences were not found for career race number or length, time between races or lay-up variables for horses with ≥1 lay-up. For both breeds, cases had fewer events, lower recent accumulated distance and fewer active days in training than controls; however, a subset of TB cases with >10 events since lay-up had a longer active career than controls. For QHs that had a lay-up, total and mean lay-up times were greater for cases than controls. Multivariable models revealed that odds ratios (OR) of Scapular Fracture were greater for TBs that had not yet raced (OR = 23.19; 95% confidence interval (CI) 3.03–177.38) and lower for QHs with more events (OR = 0.71; 95% CI 0.54–0.94). Conclusions and clinical relevance: Racehorses that are in early high-speed training but behind that of their training cohort should be examined for signs of Scapular stress remodelling. Quarter Horses that had a prolonged lay-up and TBs that have endured high-speed training for a longer duration than that of their training cohort also were at greater risk.
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characteristics of thoroughbred and quarter horse racehorses that sustained a complete Scapular Fracture
Equine Veterinary Journal, 2012Co-Authors: S A Vallance, Hailu Kinde, Susan M. Stover, Rick Arthur, Janet Moore, James T Case, Rachel Entwistle, Bradd C Barr, Mark L AndersonAbstract:Summary Reasons for performing study: To determine if Scapular Fractures occur in racehorses with distinctive characteristics. Objectives: To test the hypothesis that Thoroughbred (TB) and Quarter Horse (QH) racehorses with a Scapular Fracture have similar characteristics that are different from those of their respective racetrack populations. Methods: Necropsy findings, case details, last race information and career earnings for TB and QH racehorses that had a Scapular Fracture in California between 1990 and 2008 were retrospectively compared between breeds. Horse signalment, career earnings, career starts and race characteristics were obtained for all California racehorses. Comparisons were made between affected horses, other racehorses that died, and all horses that raced, in California during the 19 year period. Results: Seventy-three TB and 28 QH racehorses had a similar, complete comminuted Scapular Fracture with an articular component, and right forelimb predilection. The QHs had a higher incidence of Scapular Fracture incurred during racing than TBs (0.98 vs. 0.39/1000 starters). The TB and QH incident rates for musculoskeletal deaths incurred racing were 20.5 and 17.5/1000 starters, respectively; however, a greater proportion of TB musculoskeletal deaths occurred training (40% vs. 8%). Horses with a Scapular Fracture were more likely to be male and aged 2 or ≥5 years than the racetrack population. Most affected QHs (64%) were 2-year-olds; most TBs (74%) were aged ≥3 years. Scapular Fractures occurred more commonly during racing in QHs (70%) than TBs (44%). Race-related Scapular Fracture was more likely to occur in a Maiden race than in a non-Maiden race. Horses with a Scapular Fracture had fewer career starts than the racetrack population. Conclusions and potential relevance: Despite breed differences for signalment and exercise distances, both breeds incur a complete Scapular Fracture that is more likely to occur in the right scapula of young and older, male racehorses, early in their race career or after few races. Quarter Horses sustain a catastrophic Scapular Fracture more frequently than TBs.
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catastrophic Scapular Fractures in californian racehorses pathology morphometry and bone density
Equine Veterinary Journal, 2011Co-Authors: S A Vallance, Mathieu Spriet, Susan M. StoverAbstract:Summary Reasons for performing study: To enhance understanding of the nature and pathogenesis of Scapular Fractures in racehorses. Hypothesis: Scapular Fractures in racehorses have a consistent configuration related to sites of pre-existing stress modelling and remodelling. Methods: Fractured and intact scapulae collected post mortem were examined visually and with computed tomography (CT). Scapular Fracture configuration, bone modelling changes and standardised CT morphometry and density measurements were recorded. Statistical comparisons were made between Fractured, nonFractured contralateral and control scapulae. Results: Thirty-nine scapulae from 10 Thoroughbred (TB) and 10 Quarter Horse (QH) racehorses were obtained. All 14 Fractured scapulae (from 12 horses) had a consistent comminuted Fracture configuration. A complete Fracture coursed transversely through the neck of the scapula at the level of the distal aspect of the spine (8.9 ± 0.9 cm proximal to the lateral articular margin of the glenoid cavity). The distal fragment of 13 Fractured scapulae was split into 2 major fragments by a Fracture in the frontal plane that entered the glenoid cavity (2.8 ± 0.4 cm caudal to the cranial articular margin). Focal areas of periosteal proliferation and/or radiolucency were present in the distal aspect of the Scapular spine of all Fractured and intact contralateral scapulae, but less commonly (P<0.01) in intact scapula from horses without a Scapular Fracture. Fractured scapulae had 7–10% lower mean density and 46–104% greater density heterogeneity in the spine adjacent to the transverse Fracture compared to control scapulae (P<0.03). Conclusions and clinical relevance: Thoroughbred and QH racehorses have a characteristic Scapular Fracture configuration that is associated with pre-existing pathology of the distal aspect of the spine. This location is consistent with Scapular stress Fractures diagnosed in lame TB racehorses. Catastrophic Fracture is the acute manifestation of a more chronic process. Consequently, there are opportunities for early detection and prevention of fatalities.
S A Vallance - One of the best experts on this subject based on the ideXlab platform.
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case control study of high speed exercise history of thoroughbred and quarter horse racehorses that died related to a complete Scapular Fracture
Equine Veterinary Journal, 2013Co-Authors: S A Vallance, Peta L Hitchens, Rachel Entwistle, Ian A Gardner, Susan M. StoverAbstract:Summary Reasons for performing study: Identification of exercise history patterns that are related to catastrophic Scapular Fracture will facilitate prevention of racehorse fatalities. Objectives: To determine if exercise patterns are associated with Scapular Fracture in Thoroughbred (TB) and Quarter Horse (QH) racehorses. Methods: High-speed exercise histories for 65 TB and 26 QH racehorses that had a complete Scapular Fracture (cases) and 2 matched control racehorses were retrospectively studied. Exercise variables were created from lifetime race and official timed workout reports. Associations between exercise variables and Scapular Fracture were investigated using conditional logistic regression. Results: Thoroughbreds with a Scapular Fracture had a greater number of workouts, events (combined works and races), and mean event distances than QHs with a Scapular Fracture. Quarter Horses worked less frequently and accumulated distance at a lower rate than TBs. Breed differences were not found for career race number or length, time between races or lay-up variables for horses with ≥1 lay-up. For both breeds, cases had fewer events, lower recent accumulated distance and fewer active days in training than controls; however, a subset of TB cases with >10 events since lay-up had a longer active career than controls. For QHs that had a lay-up, total and mean lay-up times were greater for cases than controls. Multivariable models revealed that odds ratios (OR) of Scapular Fracture were greater for TBs that had not yet raced (OR = 23.19; 95% confidence interval (CI) 3.03–177.38) and lower for QHs with more events (OR = 0.71; 95% CI 0.54–0.94). Conclusions and clinical relevance: Racehorses that are in early high-speed training but behind that of their training cohort should be examined for signs of Scapular stress remodelling. Quarter Horses that had a prolonged lay-up and TBs that have endured high-speed training for a longer duration than that of their training cohort also were at greater risk.
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characteristics of thoroughbred and quarter horse racehorses that sustained a complete Scapular Fracture
Equine Veterinary Journal, 2012Co-Authors: S A Vallance, Hailu Kinde, Susan M. Stover, Rick Arthur, Janet Moore, James T Case, Rachel Entwistle, Bradd C Barr, Mark L AndersonAbstract:Summary Reasons for performing study: To determine if Scapular Fractures occur in racehorses with distinctive characteristics. Objectives: To test the hypothesis that Thoroughbred (TB) and Quarter Horse (QH) racehorses with a Scapular Fracture have similar characteristics that are different from those of their respective racetrack populations. Methods: Necropsy findings, case details, last race information and career earnings for TB and QH racehorses that had a Scapular Fracture in California between 1990 and 2008 were retrospectively compared between breeds. Horse signalment, career earnings, career starts and race characteristics were obtained for all California racehorses. Comparisons were made between affected horses, other racehorses that died, and all horses that raced, in California during the 19 year period. Results: Seventy-three TB and 28 QH racehorses had a similar, complete comminuted Scapular Fracture with an articular component, and right forelimb predilection. The QHs had a higher incidence of Scapular Fracture incurred during racing than TBs (0.98 vs. 0.39/1000 starters). The TB and QH incident rates for musculoskeletal deaths incurred racing were 20.5 and 17.5/1000 starters, respectively; however, a greater proportion of TB musculoskeletal deaths occurred training (40% vs. 8%). Horses with a Scapular Fracture were more likely to be male and aged 2 or ≥5 years than the racetrack population. Most affected QHs (64%) were 2-year-olds; most TBs (74%) were aged ≥3 years. Scapular Fractures occurred more commonly during racing in QHs (70%) than TBs (44%). Race-related Scapular Fracture was more likely to occur in a Maiden race than in a non-Maiden race. Horses with a Scapular Fracture had fewer career starts than the racetrack population. Conclusions and potential relevance: Despite breed differences for signalment and exercise distances, both breeds incur a complete Scapular Fracture that is more likely to occur in the right scapula of young and older, male racehorses, early in their race career or after few races. Quarter Horses sustain a catastrophic Scapular Fracture more frequently than TBs.
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catastrophic Scapular Fractures in californian racehorses pathology morphometry and bone density
Equine Veterinary Journal, 2011Co-Authors: S A Vallance, Mathieu Spriet, Susan M. StoverAbstract:Summary Reasons for performing study: To enhance understanding of the nature and pathogenesis of Scapular Fractures in racehorses. Hypothesis: Scapular Fractures in racehorses have a consistent configuration related to sites of pre-existing stress modelling and remodelling. Methods: Fractured and intact scapulae collected post mortem were examined visually and with computed tomography (CT). Scapular Fracture configuration, bone modelling changes and standardised CT morphometry and density measurements were recorded. Statistical comparisons were made between Fractured, nonFractured contralateral and control scapulae. Results: Thirty-nine scapulae from 10 Thoroughbred (TB) and 10 Quarter Horse (QH) racehorses were obtained. All 14 Fractured scapulae (from 12 horses) had a consistent comminuted Fracture configuration. A complete Fracture coursed transversely through the neck of the scapula at the level of the distal aspect of the spine (8.9 ± 0.9 cm proximal to the lateral articular margin of the glenoid cavity). The distal fragment of 13 Fractured scapulae was split into 2 major fragments by a Fracture in the frontal plane that entered the glenoid cavity (2.8 ± 0.4 cm caudal to the cranial articular margin). Focal areas of periosteal proliferation and/or radiolucency were present in the distal aspect of the Scapular spine of all Fractured and intact contralateral scapulae, but less commonly (P<0.01) in intact scapula from horses without a Scapular Fracture. Fractured scapulae had 7–10% lower mean density and 46–104% greater density heterogeneity in the spine adjacent to the transverse Fracture compared to control scapulae (P<0.03). Conclusions and clinical relevance: Thoroughbred and QH racehorses have a characteristic Scapular Fracture configuration that is associated with pre-existing pathology of the distal aspect of the spine. This location is consistent with Scapular stress Fractures diagnosed in lame TB racehorses. Catastrophic Fracture is the acute manifestation of a more chronic process. Consequently, there are opportunities for early detection and prevention of fatalities.
Lyle J Micheli - One of the best experts on this subject based on the ideXlab platform.
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delayed union of a Scapular Fracture an unusual cause of persistent shoulder pain
Medicine and Science in Sports and Exercise, 2007Co-Authors: Christine Curtis, Vivek Sharma, Lyle J MicheliAbstract:Introduction: Scapular Fractures in athletes are rare, although they have been reported in football and baseball players. Most Scapular Fractures heal with nonoperative management; delayed union is rarely a problem. Case Summary: A 15-yr-old male fell onto his posterior shoulder after he had been pushed into the boards and then fell to the ice during a hockey check. He was diagnosed with a rotator cuff injury at an outside facility. Initial radiographs were negative. The patient was not immobilized, and he continued to play hockey despite intermittent pain. Seven months later, he presented to our sports medicine clinic, complaining of an aching pain at the base of his left shoulder. Examination revealed point tenderness along the base of the scapula, restriction of shoulder abduction, rhomboid weakness, Scapular winging, and anterior impingement-type shoulder pain. A new radiograph, obtained at our sports medicine clinic, was nondiagnostic. Magnetic resonance imaging revealed increased signal on T2, with bone edema at the lateral margin of the Scapular neck. A computed tomography scan revealed an unhealed, left-transverse, subglenoid Scapular Fracture. The Fracture was nondisplaced. The patient was treated with transcutaneous electrical stimulation for 6 months and a physical therapy regimen focusing on periScapular strengthening. A final computed tomography scan, 6 months after initial presentation to our clinic, revealed healing of the Fracture. Examination was normal. The patient was asymptomatic and was able to fully return to sports without any complications. Conclusions: Although Scapular Fractures in athletes are rare, they may occur, particularly in "contact sports" that share the energies of injury seen in high-speed motor vehicle collisions. Early identification and proper management are integral to decrease symptoms and to avoid protracted disability, particularly in athletes
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delayed union of a Scapular Fracture an unusual cause of persistent shoulder pain
Medicine and Science in Sports and Exercise, 2007Co-Authors: Christine Curtis, Vivek Sharma, Lyle J MicheliAbstract:Introduction: Scapular Fractures in athletes are rare, although they have been reported in football and baseball players. Most Scapular Fractures heal with nonoperative management; delayed union is rarely a problem. Case Summary: A 15-yr-old male fell onto his posterior shoulder after he had been pushed into the boards and then fell to the ice during a hockey check. He was diagnosed with a rotator cuff injury at an outside facility. Initial radiographs were negative. The patient was not immobilized, and he continued to play hockey despite intermittent pain. Seven months later, he presented to our sports medicine clinic, complaining of an aching pain at the base of his left shoulder. Examination revealed point tenderness along the base of the scapula, restriction of shoulder abduction, rhomboid weakness, Scapular winging, and anterior impingement-type shoulder pain. A new radiograph, obtained at our sports medicine clinic, was nondiagnostic. Magnetic resonance imaging revealed increased signal on T2, with bone edema at the lateral margin of the Scapular neck. A computed tomography scan revealed an unhealed, left-transverse, subglenoid Scapular Fracture. The Fracture was nondisplaced. The patient was treated with transcutaneous electrical stimulation for 6 months and a physical therapy regimen focusing on periScapular strengthening. A final computed tomography scan, 6 months after initial presentation to our clinic, revealed healing of the Fracture. Examination was normal. The patient was asymptomatic and was able to fully return to sports without any complications. Conclusions: Although Scapular Fractures in athletes are rare, they may occur, particularly in "contact sports" that share the energies of injury seen in high-speed motor vehicle collisions. Early identification and proper management are integral to decrease symptoms and to avoid protracted disability, particularly in athletes
Lynn A Crosby - One of the best experts on this subject based on the ideXlab platform.
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scapula Fracture incidence in reverse total shoulder arthroplasty using screws above or below metaglene central cage clinical and biomechanical outcomes
Journal of Shoulder and Elbow Surgery, 2017Co-Authors: Justin C Kennon, Caroline Lu, Meghan E Mcgeelawrence, Lynn A CrosbyAbstract:Background Reverse total shoulder arthroplasty (RTSA) is a viable treatment option for rotator cuff tear arthropathy but carries a complication risk of Scapular Fracture. We hypothesized that using screws above the central glenoid axis for metaglene fixation creates a stress riser contributing to increased scapula Fracture incidence. Clinical type III Scapular Fracture incidence was determined with screw placement correlation: superior screw vs. screws placed exclusively below the glenoid midpoint. Cadaveric RTSA biomechanical modeling was employed to analyze Scapular Fractures. Methods We reviewed 318 single-surgeon single-implant RTSAs with screw correlation to identify type III Scapular Fractures. Seventeen cadaveric scapula specimens were matched for bone mineral density, metaglenes implanted, and fixation with 2 screw configurations: inferior screws alone (group 1 INF ) vs. inferior screws with one additional superior screw (group 2 SUP ). Biomechanical load to failure was analyzed. Results Of 206 patients, 9 (4.4%) from the superior screw group experienced scapula Fractures (type III); 0 Fractures (0/112; 0%) were identified in the inferior screw group. Biomechanically, superior screw constructs (group 2 SUP ) demonstrated significantly ( P INF ). There was no significant age or bone mineral density discrepancy. Conclusion Clinical Scapular Fracture incidence significantly decreased ( P
Rachel Entwistle - One of the best experts on this subject based on the ideXlab platform.
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case control study of high speed exercise history of thoroughbred and quarter horse racehorses that died related to a complete Scapular Fracture
Equine Veterinary Journal, 2013Co-Authors: S A Vallance, Peta L Hitchens, Rachel Entwistle, Ian A Gardner, Susan M. StoverAbstract:Summary Reasons for performing study: Identification of exercise history patterns that are related to catastrophic Scapular Fracture will facilitate prevention of racehorse fatalities. Objectives: To determine if exercise patterns are associated with Scapular Fracture in Thoroughbred (TB) and Quarter Horse (QH) racehorses. Methods: High-speed exercise histories for 65 TB and 26 QH racehorses that had a complete Scapular Fracture (cases) and 2 matched control racehorses were retrospectively studied. Exercise variables were created from lifetime race and official timed workout reports. Associations between exercise variables and Scapular Fracture were investigated using conditional logistic regression. Results: Thoroughbreds with a Scapular Fracture had a greater number of workouts, events (combined works and races), and mean event distances than QHs with a Scapular Fracture. Quarter Horses worked less frequently and accumulated distance at a lower rate than TBs. Breed differences were not found for career race number or length, time between races or lay-up variables for horses with ≥1 lay-up. For both breeds, cases had fewer events, lower recent accumulated distance and fewer active days in training than controls; however, a subset of TB cases with >10 events since lay-up had a longer active career than controls. For QHs that had a lay-up, total and mean lay-up times were greater for cases than controls. Multivariable models revealed that odds ratios (OR) of Scapular Fracture were greater for TBs that had not yet raced (OR = 23.19; 95% confidence interval (CI) 3.03–177.38) and lower for QHs with more events (OR = 0.71; 95% CI 0.54–0.94). Conclusions and clinical relevance: Racehorses that are in early high-speed training but behind that of their training cohort should be examined for signs of Scapular stress remodelling. Quarter Horses that had a prolonged lay-up and TBs that have endured high-speed training for a longer duration than that of their training cohort also were at greater risk.
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characteristics of thoroughbred and quarter horse racehorses that sustained a complete Scapular Fracture
Equine Veterinary Journal, 2012Co-Authors: S A Vallance, Hailu Kinde, Susan M. Stover, Rick Arthur, Janet Moore, James T Case, Rachel Entwistle, Bradd C Barr, Mark L AndersonAbstract:Summary Reasons for performing study: To determine if Scapular Fractures occur in racehorses with distinctive characteristics. Objectives: To test the hypothesis that Thoroughbred (TB) and Quarter Horse (QH) racehorses with a Scapular Fracture have similar characteristics that are different from those of their respective racetrack populations. Methods: Necropsy findings, case details, last race information and career earnings for TB and QH racehorses that had a Scapular Fracture in California between 1990 and 2008 were retrospectively compared between breeds. Horse signalment, career earnings, career starts and race characteristics were obtained for all California racehorses. Comparisons were made between affected horses, other racehorses that died, and all horses that raced, in California during the 19 year period. Results: Seventy-three TB and 28 QH racehorses had a similar, complete comminuted Scapular Fracture with an articular component, and right forelimb predilection. The QHs had a higher incidence of Scapular Fracture incurred during racing than TBs (0.98 vs. 0.39/1000 starters). The TB and QH incident rates for musculoskeletal deaths incurred racing were 20.5 and 17.5/1000 starters, respectively; however, a greater proportion of TB musculoskeletal deaths occurred training (40% vs. 8%). Horses with a Scapular Fracture were more likely to be male and aged 2 or ≥5 years than the racetrack population. Most affected QHs (64%) were 2-year-olds; most TBs (74%) were aged ≥3 years. Scapular Fractures occurred more commonly during racing in QHs (70%) than TBs (44%). Race-related Scapular Fracture was more likely to occur in a Maiden race than in a non-Maiden race. Horses with a Scapular Fracture had fewer career starts than the racetrack population. Conclusions and potential relevance: Despite breed differences for signalment and exercise distances, both breeds incur a complete Scapular Fracture that is more likely to occur in the right scapula of young and older, male racehorses, early in their race career or after few races. Quarter Horses sustain a catastrophic Scapular Fracture more frequently than TBs.
